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Thursday, November 8, 2018

A Shot In The Arm

ME: CP, what are your thoughts on this article?
CP: I read the article with interest. Who wouldn't want kids to get vaccines?
Myself: Goats need shots too!
CP: Kids, as in Children. Tiny Humans.
Myself: Of course.
ME: I sense something amiss or you wouldn't be talking to us.
CP: Well, the Senator had me agreeing with him until his brain farted this quote through his mouth: “You’re literally in and out of there in 15 minutes, as opposed to making an appointment with your doctor, waiting an hour, going through all the procedure, and ultimately it’s less expensive," Diegnan said."
Myself: Apparently he didn't speak with any pharmacists about this proposed bill.
CP: It's politics. He came up with a good idea, but ran with it and opened his mouth before researching it.
ME: Did he make sure ALL insurances will cover vaccines for children as young as 3yo at a pharmacy? Did he include language that mandated extra tech help (since many pharmacies have cut tech AND intern hours) during vaccine season? Did he allow pharmacists to receive reimbursement for the extra work through direct billing? (We have had an NPI since we started administering vaccines. Wouldn't it be nice if we could bill the insurance for the administration fee since WE are the ones administering?)
CP: Right. It's great that you're improving access to healthcare. It's tremendous and laudable and you should definitely pat yourself on the back. HOWEVER, do not guarantee how I will do my job, Senator. I'll make you a deal, Senator. Come to my pharmacy. Work with me for a couple hours. I'll show you everything I have to do in a day and you can play tech for me. When you understand my job, then you can tell people how it works. Until you pay me a visit and ask what I want or need, do not open your mouth and speak for me. It's people like you (politicians and prescribers) who speak before thinking and make our jobs more difficult.
ME: Well stated. I'd like to add that, not only should he make sure ALL insurances allow billing of vaccines for children, but that it's easy to bill medical and prescription insurance through any pharmacy. How about mandating that ALL insurances pay for preventive care for ALL patients, regardless of age? I especially like the part where the pharmacists should get paid the administration fee. If we receive prescribing rights, he should ensure that we as pharmacists get the credit for writing the prescriptions as well. I mean, it's only fair since pharmacies are paying some prescriber to use her name as a protocol doctor in many states. Pay me instead, right?
CP: Definitely.
Myself: But what about the poor goats?!


Tuesday, November 6, 2018

Monday, November 5, 2018

Shingrix Battle Royale

Uber-Tech: We got Shingrix in today!
CP: Amazing!
UT: What should we do with it?
CP: Ideally we'd administer it.
UT: Right. But how shall we decide who gets it?
CP: Good question.
UT: Call off the list?
CP: The list we shredded a few months ago?
UT: First come, first-served?
CP: Nah. There's no phun in that. People have been acting like asses every time they inquire as to our current stock. We need to exploit this behaviour.
UT: Cage match?
CP: Better.
UT: Gladiator?
CP: I like it. I'm thinking Mad Max Beyond Thunderdome.
UT: Aha. Two men enter, one man leaves!
CP: Can't you just picture it? Throw them all in the Dome and drop their walkers and canes down to use as weapons. I'd be willing to bet they'd get rather creative with their attacks.
UT: Well they have acted quite poorly throughout this whole manufacturer backorder/supply shortage over the last 6 months. They seriously act as though it is life-and-death.
CP: Exactly. Let's run with this. Perhaps we can get GSK to sponsor the Dome. We can hold matches every Friday and Saturday, before the early-bird dinner specials start.
UT: We could even have winner bracket battles for the second shot in 2 to 6 months.
CP: Yes! Repeat business. We could make cult heroes out of the winners; get them a Facebook page and twitter phollowing. We could sell the pay-per-view rights or livestream it in the nursing homes.
UT: Imagine the merchandise. Otto "The Octogenarian" Walkers. Connie "The Cardiac Kid" Canes.
CP: I like it. I think we found our new revenue stream to combat the DIR and PBM fees. We could even extend this to other medications on backorder. "Join us next week when new battles take place for Lorazepam and Methocarbamol!"

Friday, October 26, 2018

A Note To Grumpy Old Farts Pay Attention - Shingrix

It is now the end of October.
Shingrix has been practically unavailable for 6 months now.
The manufacturer can not make enough to keep up with demand. (Despite original statements they had an 18 month surplus, they burned through all stores in 4 months. Oops.)
I can't get it.
My company can't get it.
He can't get it.
His company can't get it.
She can't get it either.
Neither can her company.

So FFS, please stop blaming the pharmacists for the current situation.
Yes, we actually do know how to order products for our patients.
No, apparently you can't understand what every pharmacist has been telling you for months.
It's not US, it's THEM.

It's a shingles vaccine.
I wish you were as dedicated to getting your flu shot and Tdap as you were for Shingrix.
Remember when we had to twist your arm to sell you on Zostavax? Yeah. What changed?

You know how your family loves your wife's signature dish? Everyone asks her to make it for holidays and events? So let's pretend she's in a coma and can't cook.
You still attend all the events sans dish (and wife).
Everyone keeps asking where her dish is. (They don't care about her, they're hungry. They look forward to this dish every Boxing Day and bris and it's not here.)
Could you have made it? No. Why? She has the recipe in her head and you never bothered to help in the kitchen and learn the dish.
Now everyone gets mad at you.
It's not your fault she's in a coma.
It's not your fault you can't cook her signature dish.
Until she recovers, everyone will have to survive without.

Same goes for you and your Shingrix shot. You'll survive without.
When GSK manages to manufacture enough to meet demand, you'll get it.
Until then, STOP. PISSING. AND. MOANING like a 2 year old throwing a temper tantrum.
It's not the pharmacy's fault.
Call GSK.


The next time The Powers That Be solicit ideas for building business (it'll be the first time!), I've prepared my proposal.
A Midway Carnival.

When patients complain that their wait times are too long, what happens? (Correct, bosses cut hours.)
But how do we get the patients to wait patiently and spend more money?
We set up a bunch of booths inside the pharmacy, using pharmacy items, and challenge them to games.

1. The Balloon Dart Throw: Syringes. Step right up and give the kids a few hypodermics and let the good times roll. Employ all the kids asking for syringes for "grandma" and tell them they get to keep the used ones and it's a win-win.

2. The Ring Toss: Patrons will toss vial lids into oversized stock bottles (thinking 1000 ct bottles of Metformin 1000mg or Atorvastatin 80mg).

3. Lite Brite: For the little kids (in all of us) we can set up a giant light wall. The kids will place 60 dram vials in the circular holes over each light and make a pattern. Different colored vials will keep them entertained for seconds on end!

4. Pin-The-Tail-On-The-Doctor: Using pen needles, patients can take out their phrustrations of a long wait on who was really to blame, the doctor's office. Great stress reliever for pharmacy staff as well. (Caricature picture of the prescriber changes hourly/daily.)

5. Knife Throw: Remember those Katana Spatulas I keep making? Spin the wheel and throw the Katana Spatula at the target. Prizes every time!

Think about all the phun everyone will have while waiting for their prescriptions...and all the money they'll spend trying to win the dumb prizes.

Prizes include:
a. Pass to the front of the line on your next visit.
b. 10 minute wait on your next visit.
c. One free argument over your copay.
d. One 3-day supply because you ran out and are going to die.
e. Gift Cards Galore!
f. Pez Dispensers for Prescriptions (one size fits most)

Of course the games will be rigged and no one will win the coveted prizes but, hey, look, your prescriptions are ready!

Wednesday, October 10, 2018

Well, You Asked

CP: Welcome to the first of the month during National Pharmacy celebration time, how may I make a post out of this?
Dude Arguing Full Time: What took you so long to answer the phone?
CP: Good question. Please hold while I check.
<waits 3 minutes, 14 seconds>
CP: I asked my tech and she didn't know why it took so long.
DAFT: That's not good enough!
CP: Hold on, let me check with the pharmacist.
<waits 5 minutes, 42 seconds>
CP: Still there?
DAFT: Yes! What's taking so long?
CP: Still trying to get an answer to your first question. BRB
<<waits 7 minutes, 11 seconds>
CP: Thanks for holding. I think I discovered the problem.
DAFT: And?
CP: See, we're really busy, it being the first of the month and all. It's also the first month of the last quarter of the year which means more people getting 90 days to last through 2018; it's peak flu shot month and all the Q-Tips are coming to get theirs since October is to flu shots as Thursday is to Bingo; I only have 1 technician because corporate believes opening a pharmacy on the first Monday of the month requires only 2 warm bodies; I was on the other line while administering a flu shot from 10 paces with my Phlu-Dart 3001 (better range than the PhluDart 2999); my tech was juggling the register, drop-off, and some magic beans while also placing the phone on hold via telekenesis; and the dog ran away with the spoon. So what do you need?
DAFT: I got a text.
CP: Thanks for calling to tell me. Do you call your friends asking if they got the email you sent?
DAFT: No. It said I am due for a refill.
CP: Okay. And?
DAFT: I need it refilled.
CP: You know you could just reply with a smiley face and it will automatically refill it for you, right?
DAFT: Really?
CP: Yes.
DAFT: Can't you fill it for me?
CP: Sure. Please hold. . .

Tuesday, October 2, 2018

An Ode To Bowel Prep a la Santeria

I don't want no diarrhea
I don't want to poop at all
Twenty-four feet of intestines and I, emptied them all
If I could freeze this crap fest, and my bowels that just won't quit
Well I'd pop a cork in my gut and I'd go no more.

I don't really want to go, no baby, mmmm. . .
And literally all day I'm not fine
Loperamide I need, Oh. . .

My hole will have to withstand this attack, won't leave my heinie all alone.
Intestines gonna die large and small.
I feel the urge, feel the burn, feel the urge and I know I can't stand up.
Whoa, no, huh uh.
Well I swear and cry.

What I really wanna know, please tell me.
Am I really gonna die I know I will, Lytely I'll not Go.
My hole will have to . . .

Oh. . .
But I really want to die, just sayin'
That I really wanna die and it's now time, I won't make it, oh no it's coming out.

The Nulytely will destroy as you run to the bathroom, barricade inside
Death is coming for your insides
And if you can choke it down the end result will be so clear.
Believe me when I say that you need something for that ripped ass.

And I really wanna cry, like crazy
Oh, the inhumanity is mine to face, alone, and I'll take it.
My pride will have to wait, yeah, yeah, yeah.

Monday, October 1, 2018

Doctor Out-Of-Touch

CP: Hello and welcome to CP's Drug Emporium. How may I help you today?
Herr Doctor: I'm a doctor!
CP: Oh shit. Well, as my proctologist always says, relax and it won't hurt as bad.
HD: Huh?
CP: What brings you in today?
HD: I have a dental appointment and need 2 capsules of amoxicillin.
CP: Weird. It's usually 4 capsules but hey, you're a doctor. Are you going to write yourself a prescription?
HD: Huh? No. Why?
CP: Because that's how you get prescription medications; via prescription.
HD: I just need 2 capsules! Why won't you just give them me? I have a bottle of 100 of them at the office I get from McKesson. I have to be at my appointment now and I had to wait 3 months for this appointment!
CP: Wow, doc, you suck at planning. Also, you need to get out more. The world has changed since you graduated. Apparently you skipped the "How the Real World Works" and "Pharmacy, An Introductory Guide" classes and still graduated.
HD: Excuse me?
CP: You're either going to have to write a prescription, then wait while I make a profile for you then fill the prescription, or. . .
CP: Or you're going to have to make that drive to your office then. It looks as if I may be out of Amoxicillin too so your odds aren't good.
HD: This is ridiculous.
CP: Stupid laws. Hate 'em. By the way, where is your office located?
HD: Why?
CP: I'm going to need a physical in the future and figure that, when the urge hit me, I'd just drop by, walk into your office, pass the check in desk, and enter one of your rooms without an appointment. That's how all this works, right?